Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | 036086008 | IL |
NPI | 1093797987 |
---|---|
Provider Name | Dr. Dean G Tsarwhas |
First Address | Lake Forest, IL 60045-1659 |
Second Address | Lake Forest, IL 60045-1659 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2005 |
Last Update Date | 04/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036086008 | (05) | IL |
E86721 | (02) | IL |